Pandemic telehealth flexibilities for buprenorphine treatment: a synthesis of evidence and policy implications for expanding opioid use disorder care in the United States

Health Affairs Scholar, Journal Year: 2023, Volume and Issue: 1(1)

Published: June 20, 2023

Buprenorphine is a highly effective treatment for opioid use disorder (OUD) and critical tool addressing the worsening US overdose crisis. However, multiple barriers to treatment-including stringent federal regulations-have historically made this medication hard reach many who need it. In 2020, under COVID-19 public health emergency, regulators substantially changed access buprenorphine by allowing prescribers initiate patients on via telehealth without first evaluating them in person. As emergency has been set expire May of 2023, Congress agencies can leverage extensive evidence from studies conducted during wake pandemic make evidence-based decisions regulation going forward. To aid policy makers, narrative review synthesizes interprets peer-reviewed research effect flexibilities uptake implementation telehealth, its impact OUD patient prescriber experiences, treatment, outcomes. Overall, our finds that took advantage including audio-only option, with wide range benefits few downsides. result, regulators-including Congress-should continue nonrestricted initiation.

Language: Английский

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Access challenges to opioid use disorder treatment among individuals experiencing homelessness: Voices from the streets

Journal of Substance Use and Addiction Treatment, Journal Year: 2023, Volume and Issue: 157, P. 209216 - 209216

Published: Nov. 18, 2023

Achieving equitable access to medications for opioid use disorder (MOUD) such as buprenorphine is a pressing issue. Evidence suggests that MOUD varies by race and socioeconomic status. The COVID-19 pandemic further exacerbated the treatment gap. drivers behind this gap remain poorly understood. This study explores barriers among individuals with (OUD) experiencing homelessness. We interviewed 28 in around Boston Public Health Commission (BPHC) Engagement Center, an area known its high density of active substance asked about people's experiences, perceptions, attitudes toward OUD treatment. conducted thematic analysis our interview data. Fifty-four percent participants sampled were not prescribed MOUD. None reported having prescription sublingual or buprenorphine/naloxone. White more likely have been past compared other races even socioeconomically homogeneous sample. Themes emerged data included challenges accessing due reduced services during pandemic, lost stolen medications, fewer inpatient withdrawal management beds women, transportation challenges, fear adverse effects MOUD, perception taking replaces one addiction another, community disapproval Participants also stigma discrimination based on race, gender, Systems individual-level factors contribute across posed additional challenges. provides important, actionable insights faced particularly vulnerable population

Language: Английский

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Telemedicine in the age of the pandemics: The prospects of web-based remote patient monitoring systems for orthopaedic ambulatory care management in the developing economies

Digital Health, Journal Year: 2024, Volume and Issue: 10

Published: Jan. 1, 2024

The goal of this research was to demonstrate the efficacy telemedicine via design, implementation and evaluation a web-based remote patient monitoring system (WB-RPMS) across tertiary/university teaching hospitals in developing country Nigeria, as tool continue expand access an affordable resilient tertiary healthcare through challenging times COVID-19 pandemic or any future disruptions.

Language: Английский

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Mapping the Research on Healthcare Delivery in Business and Management in the Last Two Decades (2002–2021): A Bibliometric Network Analysis

Journal of Health Management, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 23, 2025

Healthcare delivery is an evolving field of research concerned with promoting good health and well-being for all. To comprehend the progress field, 909 healthcare records were systematically collected from 20 categories aligned to business management in Web Science database, published between 2002 2021. Later, articles analysed using Bibliometrix tool extract information on annual number publications, highest keyword co-occurrence networks thematic evolution during study period. The findings showed that United States country contribution University Washington institution contribution. Additionally, 10 significant clusters identified. shows focus now more patient outcomes adoption virtual models. This one first holistically review landscape past two decades identify relevant themes a multidisciplinary perspective, guiding researchers pursue novel studies.

Language: Английский

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Projected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study

Clinical Infectious Diseases, Journal Year: 2021, Volume and Issue: 75(1), P. e1112 - e1119

Published: Sept. 9, 2021

The coronavirus disease 2019 (COVID-19) pandemic disrupted access to and uptake of hepatitis C virus (HCV) care services in the United States. It is unknown how substantially will impact long-term HCV-related outcomes.

Language: Английский

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Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland

Harm Reduction Journal, Journal Year: 2024, Volume and Issue: 21(1)

Published: May 8, 2024

Abstract Background Substance use disorder treatment and recovery support services are critical for achieving maintaining recovery. There limited data on how structural social changes due to the COVID-19 pandemic impacted individual-level experiences with substance treatment-related among community-based samples of people who inject drugs. Methods People a recent history injection drug were enrolled in AIDS Linked IntraVenous Experience study Baltimore, Maryland participated one-time, semi-structured interview between July 2021 February 2022 about their living through (n = 28). An iterative inductive coding process was used identify themes describing affected participants’ services. Results The median age participants 54 years (range 24–73); 10 (36%) female, 16 (57%) non-Hispanic Black, 8 (29%) HIV. We identified several that acted as barriers facilitators engagement medications opioid (MOUD) (e.g., group meetings). New take-home methadone flexibility policies temporarily facilitated MOUD treatment, but other pre-existing rigid practices zero-tolerance) counteracting barriers. Changes illicit market both facilitator barrier treatment. Decreased availability pandemic-related adaptations in-person While telehealth expansion meetings some participants, faced digital technological These service provision also led diminished perceived quality virtual meetings. However, increased accessibility individual providers counselors Sponsors). Conclusions Structural across socioecological levels created new Multilevel interventions needed improve access high-quality

Language: Английский

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Differential impacts of COVID ‐19 and associated responses on the health, social well‐being and food security of users of supportive social and health programs during the COVID ‐19 pandemic: A qualitative study

Health & Social Care in the Community, Journal Year: 2022, Volume and Issue: 30(6)

Published: May 6, 2022

The effects of the coronavirus disease-2019 (COVID-19) pandemic on lives underserved populations are underexplored. This study aimed to identify impacts COVID-19 and associated public health responses social well-being, food security users Housing First (HF) services in Toronto (Canada) during first wave pandemic. qualitative descriptive was conducted from July October 2020 a subsample 20 adults with history homelessness serious mental disorders who were receiving HF Toronto. A semi-structured interview guide used collect narrative data regarding access health, preventive services. thematic analysis framework guided analyses interpretation data. response measures had variable impact well-being participants. Around 40% participants minimally impacted by Conversely, among remaining (impacted group), some experienced onset new problems (anxiety, stress, paranoia) or exacerbation pre-existing (depression, post-traumatic stress disorder obsessive-compulsive disorder). They also struggled isolation loneliness limited leisure activities goods. contributed disparities accessing healthcare treatment continuity for non-COVID-19 issues negatively Overall, most able adhere get reliable information facilitated having phone, internet media devices In conclusion, people experiences use supportive housing diverse ways.

Language: Английский

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Impact of SARS-CoV-2 lockdown on expansion of HIV transmission clusters among key populations: A retrospective phylogenetic analysis

The Lancet Regional Health - Americas, Journal Year: 2022, Volume and Issue: 16, P. 100369 - 100369

Published: Sept. 23, 2022

Public health measures designed to reduce SARS-CoV-2 transmission led reduced access care and prevention services for people living with or at risk of acquiring HIV, particularly during the initial introduction extensive restrictions. This reduction in may have contributed increases HIV not outweighed by decreases occurring as a result contact rates promoted same public measures. We synthesize available province-wide data British Columbia, Canada, together mobility phylogenetically investigate early impacts on transmission. Cluster growth, coalescent branching events lineage-level diversification were assessed "pre-lockdown" (January 22–March 21, 2020), "lockdown" (March 22–May 20, 2020) "post-lockdown" (May 21–July 19, facilitate comparison trends across key populations. Results reveal increased limited number clusters association SARS-CoV-2-related In particular, associated who inject drugs (PWID) show rapid phylogenetic trees following lockdown period, elevated median change individuals' viral compared men sex (MSM), consistent between PWID. Increased vigilance innovative targeted solutions are critical offset potential negative future pandemic-related restrictions epidemic dynamics. Funding sources include Genome Canada BC, Health Agency BC Centre Excellence HIV/AIDS, Canadian Institutes Research Coronavirus Rapid Response Programme. Student funding includes NSERC CREATE scholarship graduate fellowship.

Language: Английский

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Informal Coping Strategies Among People Who Use Opioids During COVID-19: Thematic Analysis of Reddit Forums

JMIR Formative Research, Journal Year: 2021, Volume and Issue: 6(3), P. e32871 - e32871

Published: Dec. 23, 2021

The COVID-19 pandemic has transformed how people seeking to reduce opioid use access treatment services and navigate efforts abstain from using opioids. Social distancing policies have drastically reduced many forms of social support, but they may also upended some perceived barriers reducing or abstaining use.This qualitative study aims identify informal coping strategies for among Reddit users who posted in opioid-related subreddits at the beginning pandemic.We extracted data 2 major subreddits. Thematic analysis was used evaluate subreddit posts dated March 5 May 13, 2020, that referenced use, resulting a final sample 300 were coded analyzed.Of posts, 100 (33.3%) discussed least 1 type strategy. Those included psychological behavioral skills, adoption healthy habits, substances manage withdrawal symptoms. In addition, 12 (4%) explicitly mentioned as an opportunity cessation reduction use.Reddit discussion forums provided community share support others during pandemic. Future research needs assess impact on behaviors, especially periods limited isolation, these can inform future curbing epidemic other substance-related harms.

Language: Английский

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Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(14), P. 8883 - 8883

Published: July 21, 2022

We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over first two waves COVID-19 pandemic United States (US). systematically queried LitCovid database for US-only studies without date restrictions (up 6 August 2021). extracted data from articles in: (a) illicit frequency/contexts/behaviors, (b) drug market dynamics, (c) access treatment harm reduction services, (d) use-related outcomes/harms. The majority 37 selected were conducted within metropolitan locations leveraged historical timeseries medical records data. Limited available supported frequency/behaviors/contexts use. Few point increases fentanyl reductions heroin availability. Policy-driven interventions lower thresholds conferred increased localized settings but did not seem significantly prevent broader disruptions nationwide. Substance emergency services' presentations fatal overdose showed worsening situation. Improved study designs/data sources, backed by enhanced routine monitoring trends, are needed inform effective responses during public emergencies.

Language: Английский

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